Abstract
BackgroundThe autonomous cardiovascular control can contribute to progression of migraine. However, current data on cardiovascular reactivity in migraine, especially severe forms, are essentially contradictory. The main aim of this study was to compare the autonomous regulation of circulation in patients with episodic and chronic migraine and healthy subjects.MethodsSeventy three migraine patients (mean age 35 ± 10) including episodic migraine (51 patients, 4–14 headache days/months) and chronic migraine (22 patients, ≥15 headache days/month) along with age-match control (71 healthy voluntaries) were examined. The autonomic regulation of circulation was examined with the tilt-table test, a deep breathing and Valsalva Maneuver, handgrip test, cold-stress vasoconstriction, arterial baroreflex and blood pressure variability.ResultsThe changes in heart rate induced by deep breathing, Valsalva Maneuver, and blood pressure in tilt-table test in patients with migraine did not differ from the control group. In contrast, the values of cold-stress-vasoconstriction forearm blood-flow reactivity (p <0.001), the increase in diastolic blood pressure in handgrip test (p <0.001), mean blood pressure in the late stage of the second phase of Valsalva Maneuver (p <0.001) and blood pressure variability (p <0.005) were all higher in patients with migraine than in the control group.ConclusionThus, both episodic and chronic migraine are associated with significant disturbances in autonomous control resulting in enhanced vascular reactivity whereas the cardiac regulation remains largely unchanged.
Highlights
The autonomous cardiovascular control can contribute to progression of migraine
Cardiac regulation The cardiac regulation in episodic and chronic migraine was addressed by performing the deep breathing test, calculating the Valsalva index, and by measuring the arterial baroreflex
We found that the heart rate changes induced by the deep breathing, the Valsalva index, or arterial baroreflex, as well as the initial heart rate, were not different between both migraine groups and control (p > 0.017 for all parameters, Table 2)
Summary
The autonomous cardiovascular control can contribute to progression of migraine. Current data on cardiovascular reactivity in migraine, especially severe forms, are essentially contradictory. The main aim of this study was to compare the autonomous regulation of circulation in patients with episodic and chronic migraine and healthy subjects. The activation of the trigeminovascular system comprising somatic and autonomous nerves and meningeal vessels, plays a central role in the pathogenesis of migraine [1,2,3]. Pathophysiological mechanisms leading to migraine chronization remain largely unknown. It is remains unclear whether the chronic migraine is associated with different neuronal mechanisms including function of autonomous nerves [8]. Current evidence suggests that pathophysiologic mechanisms of migraine persist even in the interictal.
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